Reducing-tension step by step in epicanthus and lower eyelid incision for treating cilial entropion in children A case series analysis

Objective To evaluate the surgical outcomes of a modified technique for treating congenital cilial entropion in children, which involves reducing tension step by step in the epicanthus and lower eyelid incision. Methods The observational group consisted of 153 pediatric patients (81 males, 72 females) who underwent the modified technique, while the control group included 124 patients (68 males, 56 females) who underwent rotating suture surgery. All the participants were bilateral. Surgical outcomes were classified as good, fair, or poor, and recurrence rate, scar condition, inferior eyelid position, and patient satisfaction were also assessed. Results The mean follow-up period was 9.13 ± 3.50 months (range: 3-14 months) for the observational group and 6.93 ± 4.51 months (range: 3-14 months) for the control group. In the observational group, surgical success with a "good" outcome was achieved in 300 eyes (98.04%), compared to 224 eyes (90.32%) in the control group. No recurrence occurred in the observational group, while the recurrence rate in the control group was 4.43%. Postoperative scar formation was mild in the observational group. The average scar score was 1.27 ± 0.96 in the observational group and 2.70 ± 0.99 in the control group, with a statistically significant difference (P < 0.001). Neither overcorrection nor postoperative ectropion was observed in both groups. Conclusion The modified technique effectively corrected medial entropion and trichiasis in the lower eyelid, resulting in stable postoperative outcomes, mild scar formation, quick recovery, flexible eyelid motility, and stable ocular surface. It can be widely applied to children with congenital entropion and trichiasis.